Public health funding cuts are undermining programs that protect Americans from infectious disease outbreaks, bioterrorist attacks, and natural disasters, according to a Trust for America’s Health reportreleased on Tuesday.

“We’ve documented how preparedness has been on an upward trajectory” over the past 10 years, said Trust for America’s Health director Jeff Levi. “But the economic crisis has changed the story. Now we’re seeing a decade’s worth of preparedness eroding in front of our eyes.”

Funding reductions could affect preparedness gains made since 9/11, Levi said. The cuts could impede communities’ ability to distribute vaccines, test for chemical and biological agents, and coordinate disaster response.